Own the end-to-end credentialing and payer enrollment process for behavioral health providers across multiple states.
Manage internal credentialing onboarding for newly hired providers by collecting and validating required documentation.
Design and maintain credentialing and enrollment tracking systems to monitor application status, renewal timeliness, and enrollment milestones as the company scales.
Coordinate the end-to-end provider enrollment process for physicians, nurse practitioners, and physician assistants joining the medical group.
Prepare and submit enrollment applications to Medicare, Medicaid, and other applicable payers to establish billing privileges.
Maintain accurate provider data within internal systems (e.g., NPPES, PECOS, CAQH, and iCIMS/HRIS) to ensure consistency across platforms.
Curana Health is dedicated to radically improving the health, happiness, and dignity of older adults. They are a national leader in value-based care, serving 200,000+ seniors in 1,500+ communities across 32 states and employing more than 1,000 clinicians plus other professionals.
Enrolling practitioners in health plans in a timely and effective fashion.
Monitoring progress and ensuring timeliness of enrollment completion.
Maintaining provider enrollment goals for all divisions.
Pediatrix Medical Group provides specialized health care for women, babies, and children. Since 1979, Pediatrix has grown into a national, multispecialty medical group committed to coordinated, compassionate, and clinically excellent services.
Manage the end-to-end process of licensing applications.
Coordinate the initial credentialing and re-credentialing processes for licensed providers.
Maintain accurate and up-to-date records of all licensing and credentialing activities.
InStride Health delivers specialty anxiety and OCD care. They combine research-backed clinical care and innovative technology to eliminate the major problems with care today, and become the nation’s most trusted provider of pediatric anxiety and OCD care.
Define and execute the long-term vision for credentialing and enrollment, transitioning from manual processes to a tech-enabled, scalable operation.
Oversee the end-to-end enrollment process for Medicare, Medicaid, and Commercial payers. Be the primary liaison for enterprise contract activations.
Lead the internal Credentialing Committee, presenting provider files and ensuring all primary source verifications (NPDB, OIG, SAM) are flawless.
Foodsmart is the leading telenutrition and foodcare solution, backed by a robust network of Registered Dietitians. Their platform is designed to foster healthier food choices, drive lasting behavior change, and deliver long-term health outcomes. At Foodsmart, their mission is to make nutritious food accessible and affordable for everyone, regardless of economic status.
Manage the credentialing and re-credentialing processes for physicians, nurses, and allied health professionals.
Verify licenses, certifications, education, training, and work history to ensure providers are fully qualified.
Maintain accurate and complete credentialing files, ensuring all staff are cleared before providing care.
Curana Health focuses on improving the health, happiness, and dignity of older adults. They are a national leader in value-based care, with over 1,000 clinicians serving 200,000+ seniors across 32 states.
Manage and maintain accurate provider credentialing files and profiles.
Support Clinical Operations including Provider communications.
Coordinate full-cycle credentialing, re-credentialing, and insurance contracting.
SimpliFed is focused on providing maternal health services. The company appears to be a startup with a focus on innovation and improving women’s health.
Execute non-delegated credentialing process for new and existing providers.
Serve as a point of contact for all insurance payor relationships.
Maintain accurate and up-to-date records of all credentialing activities.
Dental Care Alliance's mission is to advance the practice of dentistry by partnering with and supporting dental professionals to create a lifetime of healthy smiles. Headquartered in Sarasota, Florida, DCA supports over 400 allied practices and supports over 900 dentists across over 20 States.
Lead and develop a team of Payer Enrollment Coordinators and Specialists.
Manage and improve the systems that help support the team’s processes.
Medallion provides a provider operations platform to eliminate administrative bottlenecks. They are ranked No. 3 on Inc. Magazine’s 2024 Fastest-Growing Private Companies in the Pacific Region and have $130M in funding.
Manage complex provider roster creation, submission, and record reconciliation.
Oversee resolution of moderate-scope issues by prioritizing tasks.
Serve as main contact for roster inquiries, collaborating with internal teams and external payers.
Aledade empowers independent primary care practices to deliver better care and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Regularly engage with patients and track their adherence to their care plans.
Closely monitor your patients' device readings and dig into any out-of-bound values.
Maintain meticulous records of patient interactions, and program details.
Medsien is a leading provider of scalable remote care management, enabling healthcare practices to enhance patient engagement, improve outcomes, and optimize operational efficiency. Hundreds of organizations trust Medsien’s unparalleled technology solutions to implement exceptional remote care management programs, personalize every interaction, and improve the lives of those who need it most.
Guide healthcare providers through the reimbursement process, including prior authorizations and appeals.
Work with insurance companies and third-party administrators to address coverage issues.
Provide education regarding insurance benefits and financial assistance programs.
Amplity is a full-service go-to partner of biopharma companies that delivers flexible + specialized medical + commercial services. Amplity transforms how breakthrough treatments reach the people who need them with expert-led teams delivering contract medical, commercial + communications excellence for 40+ years.
Oversee daily operations and performance of Provider Enrollment Specialists.
Monitor team performance against standards and address gaps.
Provide coaching and development to strengthen team capability.
EnableComp provides specialty revenue cycle management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM intelligent automation platform to improve financial sustainability. They are a multi-year recipient of the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years.
Supports coding and documentation quality assurance.
Performs internal audits to assess compliance and quality.
Researches coding, billing, and charging compliance issues.
Presbyterian Healthcare Services is dedicated to improving the health of patients, members, and communities. They are a locally owned, not-for-profit healthcare system with nine hospitals, a statewide health plan, and a growing multi-specialty medical group, employing nearly 14,000 individuals.
Ensuring accurate and timely documentation in the EHR system.
Collaborating with cross-functional teams to support patient care and billing efficiency.
Phoenix Med Health is an innovative physicians network delivering high quality healthcare to elderly patients in assisted and independent living communities, group homes, and private homes. Phoenix Med Health has 50+ full-time healthcare clinicians and is rapidly expanding the house-call network model with telemedicine.
Responsible for coding procedures and entering charges to comply with regulations and internal policies.
Coordinate with Practice Coordinator and Revenue Integrity to assure all necessary documentation is present.
Participate in audits to evaluate if all selected codes are accurate and develop methodologies to improved coding issues.
Northside Hospital is an award-winning and state-of-the-art hospital that is continually growing. They are expanding the quality and reach of their care to patients and communities which creates more opportunity for healthcare professionals in Atlanta and beyond.
Engage potential patients over the phone and provide information about our healthcare service.
Assist patients in navigating the program app/website and address any technical issues.
Record and maintain accurate patient information in our system, including insurance and clinical updates.
Aviary is a healthcare company focused on leveraging technology to improve clinical outcomes. The job posting does not mention company size or discuss company culture.
Own critical components of the provider lifecycle, driving readiness to see members on the platform and scalable growth.
Identify bottlenecks and implement improvements that accelerate time-to-platform and strengthen provider engagement.
Improve systems and workflows through automation and process design, reducing manual work and operational risk.
Maven is the world's largest virtual clinic for women and families, aiming to make healthcare accessible for everyone. With over 2,000 employers and health plans as clients, Maven provides comprehensive support spanning fertility, maternity, parenting, and menopause. He fosters an award-winning culture.
Actively market Nomi Pay services to healthcare providers via phone, email, and other digital channels.
Engage with physicians, hospitals, and healthcare organizations to promote Nomi Pay’s benefits.
Proactively follow up on both new and existing leads to drive provider enrollment.
Nomi Health is rebuilding the healthcare system to provide clear prices and faster payments, focusing on improving patient care. They are a team of 300+ people challenging the status quo to build better healthcare solutions in partnership with employers and public sector organizations.
Manage multiple channel interactions with excellent communication skills.
Effectively present and discuss products and services to providers.
Establish and maintain positive relationships with providers.
Capital BlueCross is an independent licensee of the Blue Cross Blue Shield Association. We are an equal opportunity employer committed to a culture of diversity and inclusion.
Perform outbound calls to obtain appropriate information and document accurately.
Answer in-bound calls and assist customers with pharmacy related services.
Contact insurance companies for benefit investigation and coverage eligibility.
IQVIA is a global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. They create connections that accelerate the development and commercialization of innovative medical treatments to improve healthcare and patient outcomes.